Surgical Extraction & Bone Grafting

Extraction Site Preservation

There is a special type of bone surrounding your teeth. This bone is called alveolar “ridge” bone (jaw bone), and exists solely to support your teeth. As soon as the tooth is removed, this bone begins to degenerate and “melt away”. The overlying gum tissue melts away with the alveolar bone and thins out as the ridge flattens. This occurs in two dimensions. The first is loss of horizontal width caused by the collapse of the bone surrounding the tooth socket. This makes the remaining ridge narrower than when the tooth was present. The second is a loss of vertical height. This makes the remaining bone less “tall”. This process is faster in areas where you wear a partial or complete denture.

You have many options to prevent this, and it is important that you consider them BEFORE any teeth are extracted. Some of these procedures are best performed at the time the tooth is removed.

When you need to have a tooth or teeth extracted, whether extraction is due to tooth decay, fracture, abscess, gum disease or traumatic injury, a socket site preservation is recommended to preserve as much of your underlying jawbone as possible for your future restorations.

You will always have several choices for replacing newly missing teeth. All of the options rely on bone support and bone contour for the best function and esthetics. Here is a list of possible options for tooth replacement.

  • Dental implants: These are root-shaped supports that hold your replacement teeth. The more bone support you have, the stronger the implant replacements will be. In some cases, the bone can degenerate to a point where implants can no longer be placed without having more complex bone grafting procedures to create the necessary support. Obviously, preventing bone loss is much easier that recreating the bone later.
  • Fixed Bridge: This is a restoration that is supported by the teeth adjacent to the missing tooth space. The replacement tooth or “pontic” spans across the space. If the bone is deficient, there will be an unsightly space under the pontic that will trap food and affect your speech.
  • Other replacement alternatives include removable partial or full dentures. These often perform better with more supporting bone as there is added support against dislodgement.

Procedure

There are two important phases in retaining your alveolar ridge during and after the tooth extraction.  Non-traumatic extraction techniques are designed to preserve as much bone as possible and reduce bleeding and discomfort.  Following non-traumatic extractions, bone replacement material is added to the extraction socket to prevent the collapse of the socket. 

There are several types of bone grafting materials and techniques.  Our dentist will discuss the most appropriate one with you.  After the tooth is extracted, the socket will be packed with bone or bone substitute and covered with an absorbable or Teflon membrane then sutured.  Early on, the grafting material will support the tissue surrounding the socket, and in time will be replaced by new alveolar bone.  This bone will provide an excellent support should you choose restorative treatment with dental implant-supported replacement teeth in the future.

Although the bone created by socket grafting supports and preserves the socket, it will not do so indefinitely.  Placing dental implants 5 – 12 months after the extraction and socket grafting will provide the best long-lasting support for preserving your jawbone and allow you to function as before as well as prevent future degradation.

In some selected cases it is possible to actually extract the tooth and place the dental implant at the same time. 

Latest Technology

Dr. Ted Filandrianos DMD FAGD & Associates LLC is committed to providing patients with quality dentistry that utilizes the latest in dental technology and materials. Our Newton Centre dental office uses Keystone dental products for all of our bone grafting procedures. Keystone Dental is dedicated to delivering the utmost quality in our bone grafting products and ensuring your safety. Our products undergo processing steps to make the risk of disease transmission remote.

We strictly adhere to tissue banking standards as provided by the

  • Food and Drug Administration (FDA)
  • Clinical Laboratory Improvement Amendments (CLIA)

Sterilization is achieved through electron beam (e-beam) irradiation after packaging is complete to destroy any microorganisms without negatively affecting the bioactivity of our DBM products.

Keystone's bone grafting substitute products contain demineralized bone matrix (DBM). DBM has been used safely for 50 years.

Keystone Dental's adherence to strict donor-screening and tissue-testing standards and regulations ensures that you receive the highest level of safety and quality bone graft products.

Testimonials.

Read what people are saying about us.

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Testimonials

7/9/2019--Over the past several years I had a number of dental problems which were addressed by several Doctors in the Dr. Ted Filandrianos and Associates Service. These included regrouping of some teeth (Dr. Steve Bader), installation of implants (Dr. John Govostes) and restoration (Dr. Ted Filandrianos). In all cases I found the service and the quality of the work to be of the highest quality. The regrouping of the teeth and the installation of implants were very successful. Dr. Ted Filandrianos in particular, with whom I had interacted for a longer period of time, in addition to his outstanding technical skills and the use of state of the art digital imaging tools, he worked patiently over a number of months to address difficult anatomical problems towards an excellent outcome. Also, the Dental Assistants, that I interacted with during my treatment, were very skillful and highly professional. Similarly, I found Zuzana, the dental hygienist, to be highly professional and skillful. She makes your periodic visits to be something you look forward to it rather than to dread it. It will not be an exaggeration if I say that Zuzana is the best hygienist I have had during my entire life. Finally, Emily and Ali, who run the front office, are highly professional. They were always strive to accommodate the patient's needs and time requirements. Particularly, if you are facing a dental emergency they will always figure out ways to accommodate you. In conclusion , during my long life with a number of difficult dental problems I sought treatment in a number of dental services in the Boston area. I found the dental care that I received by the Dr. Filandrianos and Associates Service to be by far the best.

Theodore Moustakas

06/19/19--A recommendation for a dentist: His skill, his up to date equipment (computer driven replacements of tooth decay) and the efficiency of his office.
Dr. Filandrianos is the most efficient, and thoughtful and - yes - pain free doctor in his field that I have ever encountered. I have had dental work done in Ohio, Washington , New York, Baltimore, Guatemala city and Panama city....and the care and treatment I have had from"Dr. Ted", as he is known, surpasses them all. He is a very kind person. His staff is always excellent, considerate and efficient. His notifications of appointments and willingness to make changes in scheduling , when necessary, have made him and his office people and dental assistants the most appreciated in their field, I cannot give a higher recommendation . I am grateful to have found this office whenI first came to live in Boston.

Gay P. Lord

06/18/2015--Carolyn Z.

I wish there were a Yelp "location" category called "The Universe"...because Dr. Ted Filandrianos and the outstanding dental team in his Newton Centre office are the absolute BEST in the Universe.

I should know. I've had it all there...cleanings, fillings, root canals, extractions, bone grafts, implants, crowns...and every single treatment was performed impeccably...and as an added treat, with chair-side manners that make you feel relaxed, anxiety-free and...dare I write this about a dental experience?...well-loved! Dr. Ted and his colleagues will do everything they possibly can to save a tooth. And when they can't, these brilliant, topnotch specialists will spring into action with their specialties...and save the day!

Dr. Ted has saved or restored so many of my teeth. He is the perfect blend of scientist and artist and his work is second to one. Add to that the warmest and most empathetic treatment I've ever received from a dentist (I used to dread the dentist!) and you have, as I said, the best dentist in the Universe. I also want to say that if you ever, ever need a dental implant, and I needed two...and a bone graft...right after an extraction of an infected tooth...and you are nervous about it...periodontist Dr. Jean-Marie Biebuyck aka "Dr. B" will remove that anxiety when he puts his talents to work. I could not believe it. He calmed me, he assured me that all was going well, he made me laugh a few times and, most importantly, he was visibly proud of how well each procedure turned out and put me at ease each step of the way.

And how about those dreaded root canal treatments? Not here. Just this past weekend, I was in horrific pain from an infected lateral incisor (top). Dr. Ted put me in touch with my now-hero Dr. Barry Goldberg, the endontist in his office - and Dr. Goldberg called me and put me on an antibiotic immediately (on a Sunday!) so that I'd be prepared for the next day's root canal appointment. His chair-side manner is exceptional as well...and he put me at ease from "hello". I love how he explains what's going on with the tooth while we look together at the x-rays - and the steps he is going to take. Even the way he administers Novocaine is a pleasant experience if you can believe that. I just went back yesterday so Dr. Goldberg could fill the canals and put a temporary filling - and everything went perfectly. No more pain - and he saved my porcelain crown...he was so careful when working on it! Next step - permanent filling with Dr. Ted.

I could go on and on (which I already have!) but I also need to mention that Zuzana is an outstanding dental hygienist who knows I can act like a 3-year old baby when it comes to the probing during a cleaning - and she makes it as painless as possible with her talent and skill.

And the dental assistants (I apologize for not remembering all the names from the past several years) are wonderful...topnotch...and a huge component of the overall positive experience I've had in Dr. Ted's office...so I want to thank Marina and Wendy for being the best and taking good care of me.

Now...last but in no way least...I need to give a shout out to the very professional and vibrant Emily and Ali who are at the front desks - and who help ensure that Dr. Ted's practice runs smoothly. Whether it's a phone or in-person conversation, you will feel like the only patient in the practice...because of how Emily and Ali greet you, treat you, listen to you and reassure you that you are in the best dental office...in the Universe! Dr. Ted struck gold when he found them!

But don't take my word for any of the above. Experience it yourself - and you'll see what I mean!

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Theodore Filandrianos, DMD | 1400 Centre Street, Suite 101, Newton Centre, MA 02459

Phone: (617) 440-9198